My DD is three weeks old, and we have been breastfeeding exclusively. We had difficulty with latch the first few days so my LC gave me a contact nipple shield because my nipples were not everting. When she was a week old, we went straight to the breast, and I have been using nipple shells to help evert my nipples. HOWEVER, I do not think my baby is latching on correctly. Her mouth is definitely not opened to 140 degrees, and sometimes her lips are not even flanged. I think that she is just nursing on my nipple, probably because I taught her a bad habit through the nipple shield. She has the appropriate number of poops and pees each day, but I am concerned about her weight gain. We go in for weight checks every week. Last week she gained 6.5 ounces, but this week she only gained 3 ounces. She is also fussy after she leaves the breast and doesn't fall off spontaneously and her limbs do not go "limp" to indicate that she is getting full. She often continues to "root" after a nursing session. My LC is out of the country for three weeks (will be back next Friday) and I would hate to find a new one since we have developed a good relationship. I'm afraid it's too late to fix my baby's latch, and I don't want my milk supply to decrease in the meantime. I have been pumping after each nursing session to compensate for the poor latch. How do I know if she's getting enough in the meantime, since I can't go in for a weight check every day? Are poops and pees good enough of a gage? Should I start supplementing with the milk that I have stored? Could she be fussy for other reasons other than not being full? How long should I leave her on the breast since I'm not sure if she's getting enough?

I'm sorry I have so many questions. I really don't want to give up. So many of my friends have discouraged me from continuing because of the whole weight issue, but I DON'T want to quit. Any advice would be appreciated!

August 3rd, 2007, 03:37 PM

@llli*lactojen

Re: LC out-of-country...PLEASE HELP!

Hi there!

You sound very concerned! Let's see if we can address a few of your concerns :hug

What was your baby's birthweight? Lowest weight? What is it now? We like to see a baby gain an AVERAGE of 4-7 oz/week. So with 6.5 one week and 3 the next week, she's still probably right on track, but I would like to know her weight history.

I'm not sure where you heard that baby's mouth needed to be open 140 degrees? Honestly, that's something I've never heard. Are you having any nipple pain or damage? We like to see a good, deep latch that is painless for mom. If you are worried about your baby's latch, DO NOT wait 3 weeks. Find a LLL Leader or another LC. The LC that is out of the country will understand. It's ABSOLUTELY not too late to fix this! But the sooner the better!

Baby should be fed on demand. This means whenever she acts hungry. During the first few months, babies go through several growth spurts and they may act as if they just can't get satisfied. This is normal (as long as she is having plenty of wet and dirty diapers) and you just need to ride with it so your body can keep up with her changing needs. They usually last just a few days to a week.

Finish the first breast first. Let her nurse until she falls asleep or comes off on her own, then offer the second side. Let baby determine the length and frequency of the feedings. If she's having really prolonged feeds and you still think she isn't latching well, then fixing the latch may help with that. Sometimes they "crimp their straw" if they latch too shallowly.

No nipple pain, but her suckling doesn't feel very strong, almost like a tickle, but I do hear swallowing and I see a "pause" in her chin as if her mouth were filling up with milk. I don't think she's getting very much of the bottom of my areola in her mouth.

Regarding 140 degrees, I read it in an Ameda product handout that I received at a breastfeeding class that I attended before the baby was born. It said that was a good indication that the baby was latched on appropriately and that I should feel a deep sucking.

Should I start giving supplemental bottles?

August 3rd, 2007, 05:19 PM

MichelleE

Re: LC out-of-country...PLEASE HELP!

Hi, I'm also fairly new (not an expert by any means), but before I went to bed I just wanted to second what LactoJen said and :hug . There's nothing worse than being worried on a Friday night and having to wait until Monday. Do what you feel comfortable with re: LLLleader or LC, but my leaders were great and in my personal experience more than capable of helping me latch and verifying she was eating well. In the early days it was very difficult for me to know what was going on, and it really helped for me to have my leader just watch and advise. She showed me a miraculous technique to get my dd to open wide and it was like night and day for me. Your LC will be back in a week, right? In the meantime I definitely think it wouldn't hurt to have someone to support you in this. Are you going to any meetings? Do you have any other friends who bfeed that can help with your friends who are concerned about how much she's getting?

The weight issue drives me crazy. I sometimes wish I could just calm down about it completely. My baby plateaued last week and didn't gain or lose anything, then all of a sudden yesterday she had gained 100 grams since the last weigh (and even after a big pee). So, as Jen said, you might still be right on track. I can tell you from experience that my stress over this didn't help *at all* so my advice is to keep an eye on it but not to obsess over it and look at other cues as well (happiness, diapers) to get a gauge on things. And pat yourself on the back for sticking with it and being determined to get the help you need instead of giving up. I hope you can find some local support because it's difficult when loved ones (who mean well) propose the bottle instead of supporting bfeeding.

In the early days I can't say that I felt a deep sucking. Now I definitely can, but I wasn't sure at all in the beginning what was a meal and what was being pacified. My daughter could stay on longer than an hour if I let her. Now I know to encourage her with breast compressions and such, but I always worried if she was still hungry. The fact that you can hear sucking and swallowing is already a great sign, because it took a meeting with my leader to get that fixed.

About the bottles...that's up to you and what you think is best; I'm not sure if it's necessary or not, so I hope someone else can give you expert advice. I have a supplemental nursing system that I don't get much use out of because my baby is too fussy for that, but if yours stays latched on you could try that. Some people use a syringe, and I personally use a baby spoon to give her a little extra (for both our benefit). Yours may be too young for a spoon; I'm not sure. I only started with that somewhat recently. And it might not even be necessary anyway, except maybe to reassure you a bit to know whether she's really still hungry or not.

Hang in there.

August 3rd, 2007, 07:14 PM

@llli*lactojen

Re: LC out-of-country...PLEASE HELP!

Okay, she's surpassed her birthweight in three weeks. That's fabulous and right on track. The lack of pain and the sounds of regular swallowing are excellent signs too.

How many wet/dirty diapers is she having? How many times is she going to the breast per 24 hours?

Jen

August 3rd, 2007, 07:33 PM

mommywilcox

Re: LC out-of-country...PLEASE HELP!

She has at least four really good dirty diapers and a few small ones, but my LC said to count them if they were at least the size of a quarter. She has at least 6 wet diapers, and they're usually pretty soaked.

She goes to the breast a MINIMUM of 8 times, but usually at least 9 and sometimes even 10. However, the amount of time of each feeding is not always consistent. Sometimes she'll feed for a total of 40 minutes, and sometimes it's only about 20 minutes total.

Thank you so much for all of your encouragement and advice!

August 3rd, 2007, 08:23 PM

@llli*lactojen

Re: LC out-of-country...PLEASE HELP!

That sounds absolutely perfect! We like to see AT LEAST 2-3 dirty diapers, 5-6 wet disposable (6-8 cloth), and going to the breast at least 8-12 times or more per 24 hours. Based on that, I would say that you don't need to supplement her at all.

Hang in there mama! You're doing GREAT! :ita
Jen

August 8th, 2007, 03:36 AM

mommywilcox

Re: LC out-of-country...PLEASE HELP!

We went in for another weight check yesterday, and she weighed 7 lbs. 13.5 oz. which means that for another week in a row, she only gained 3 oz., and my doctor wants her to be gaining at least 4 a week. She didn't mention anything about supplementing though. Sometimes when she is nursing I can hear her gulping and I can actually hear the milk in her throat and mouth, and at other times, I don't hear that sound, but I do hear her swallowing. Does that mean that she's not getting any milk? Also, sometimes when I squeeze my right breast nipple, nothing comes out right after or right before I nurse. Could that mean that she's not getting anything from that breast? At other times though I can manually express milk from that breast.

I know I sound worried...I am!! My husband nor I are petite by any means and are both tall and of average build. I hate hearing that she is in the 25th percentile!! Would she have asked me to supplement if she was really concerned? This week (since I last posted) her poops have become bigger and her pees are even more saturated and heavier, so I know that she's intaking SOMETHING! :) Any additional advice would help (at least ease my mind!).

Well, she's close to what we need to see for the week :D How is her latch doing now?

The gulping/swallowing sounds are good signs that she is swallowing milk. She wouldn't be swallowing if she wasn't getting any milk. Not being able to express any milk just before or after nursing does not mean that she's not getting anything from that side--most of the milk comes out during letdown, which usually happens in the first few minutes of the nursing session.